Endoscope



July 25, 1950 F. J. WALLACE ENDOSCOPE 2 Sheets-Sheet l Filed- Jan. 31,1946 (Zh/nuca '77 doa/v1@ A TORNEY July 25, 1950 F. J. WALLACE 2,516,494

ENnoscoPE Filed Jan. 51. 1946 2 sheets-sheet 2 Patented July 25, 1950ENDOSCOPE Frederick J. Wallace, New York, N. Y., assignor to AmericanGystoscope Makers, Inc., New York, N. Y., acorporation of New YorkApplication January 31, 1946,Serial No. 644,478

9 Claims.

This invention relates to endoscopic instruments, 'and more particularlyto such instruments adapted to be introduced into and operated in bodycavities with greater facility, and having improved characteristics.whereby discomfort to the patient is minimized.

It is an important object of lthis invention to provide an endoscopicinstrument having certain parts so arranged as to facilitate itsintroduction and Withdrawal intoand out of body passages, and tomaterially reduce the possibility of the instruments being inserted inpassages other than those intendedby the operating surgeon.

.Another object of the invention is to provide an instrument of thecharacter indicated that is adapted to be moved through more or lesstortuous body passages without tearing or otherwise injuring body tissueconstitutingpart .of the wall of the passage, such as in theregio-n ofthe eX` teriorvesical sphincter, in the. courseof manipu# lation.

Another object of the invention is to provide anendoscopic instrument.having a. plurality of` fenestras formed in its sheath `and an examiningtelescope rotatably mounted in vthe sheath'in a manner to bring eachfenestra successively in the a catheterr or operating instrument,asrequired.

To Vthe end that theseobjects may be attained, aninstru-ment constructedin accordance with thisinvention may .include a iirst devicecomprisingian endoscopic tube having a plurality of lateraln fenestras.formed .therein .and .spaced there-v around; a second device comprisingan examining ities without injury to the walls of suchcavities.4

By this arrangement, the instrument of this invention readilyaccommodates itself to bends in body passages and may be used in placeof conventional instruments having either fixed concave or convex beaks.As will be readily apparent to persons versed in the art, the presentinstrument is capable of .being advantageously employed as either acystoscope or a urethroscope.

One of the features of .this invention resides in the provision of animproved arrangement .of elements for impartingdeflection to a catheteror the like at the will vof the operator. vThisin- .cludes a pivoteddeflector..that.is adapted to be positively maintainedin desiredposition, thereby obviating the possibility of its being accidentallymoved during use.V

VThe above enumerated objects, --as well'as other objects, together withthe advantages of this invention, will be readily. apparent to vpersonsskilled in theart by-reference to the. followingdetailed description,ktaken in .conjunction with the annexed drawings, which respectivelydescribe-and .illustrate, by way ofexample, an instrument constructed inaccordance with the invention.

telescope having a portion thereof inthe vrst device and. capable ofincluding. any-one o-f `the fenestrasinits field of vision, dependingupon its relative angular position with respect to theiirst Y,

movement betweentherst and second devices'.

.The endoscopic Vtube is provided` with a beakA or forward extensionforming a universal connection therewithppreferably,in the nature of. a

ball-i and socket joint,-tofpermit' free .movement ofthe forward- :endpart ortherstdevice, and. to

In .the drawings: Figure 1 is aside .elevation view of an endoscopicinstrument'embodying thedevices of .this

. invention;

Figure 2 corresponds. toFigure i, and depicts certain ofthe parts incentral vetrical 'cross section; y

Figure 3 is a cro'ss-sectionalview taken along line 3-3 of Figure l;

Figure 4 is -an enlarged cross-sectional view taken along line 4--4 ofFigure 1;

YFigures 5 andk 6 are transverse. cross-sectional views taken alonglines 5 5 and 6--6, respectively, of .Figure 2;

Figure 7 is an enlarged view of the instrument shown in Figure l, withcertain parts omitted, with parts broken vaway,'and with other parts incentral vertical cross section, to better illustrate the deflector anddevices for actuating the same;

y Figure. 12 is an enlarged vertical cross-sectional of fenestras l1 andI8 formed therein and spaced therearound. A forward extension |9consists of hollow first and second units 2D and 2|, respec-y tively.Unit 213 is externally threaded at its rearward end to engagecorresponding internal threads in the front end of tube |6 and isprovided with a rounded or ball forward end 22 that hasan integralforwardly projecting spring guide 23. The term roundedj as used hereinand in the appended claims, is intended to include any curved surface,whether in the nature of a portion of a spherical surface or otherwise.The open or rearward end of unit 2| embraces rounded forward end 22 ofunit 20 and is peened over or rolled to obtain a freely movable ball andsocket `ioint or universal connection between these units. .Acompression spring 24 is contained within unit 2| and normally urgesthat unit toward the left (Figures 2 and 3) to obtain intimate contactbetween the rounded end of unit 2! and the open end of unit 2|. The freeend of unit 2| is also rounded or blunted to permit its readyintroduction into and movement through a body passage.

As is best shown in Figure 4, a ring 25 of electrical insulatingmaterial is positioned across the interior oi tube IB adjacent theforward extremity.

such apertures being represented by diametrcally opposed notches 4| and42 (Figures 2 and 14).

Concentrically and rotatably mounted on the rearward portion of tube isa device 45, including a sleeve 45 carrying a stud 41 that rides in anannular groove or raceway 4B formed in tube Secured to the rearwardendof sleeve 48 andl rotatable therewith is a locking unit 50 that has alaterally extending operating handle 5l and that is preferably the sameas or similar to the locking mechanism disclosed in Reinhold HQ WapplerPatent No. 1,880,551 granted October 4, 1932, to which reference may behad for details of construction.

Sleeve 4-5 carries a detent means 55 illustrated in detail in Figures 12and 173, to which reference is now had. Detent means 55 includes anupstanding tubular post 5E having a pair of aligning Slots 51 and 58 andbeing externally threaded at its lower end portion for reception in atapped blind bore 59 in sleeve 46. Slidable along post 56 is a cap B0having an inner tubular wall 6| slotted at 62, and a concentric outertubular wall .263. As is shown in Figure l2, tubular walls ,6|

modate the forward and rearward ends, respectively, of a latch element6G that extends through t, .and beyond slots 51 and 58, and that ispivotally mounted in post 56 on a pivot pin |51. A laterally projectingstop pin 68 aixed to post 55 terminates in slot -62 and serves the dualfunction of limiting axial movement of cap 50 in either di- .,zrectionalong the post, and preventing rotational` movement of the cap withrespect to the post. A compression spring B9 is positioned within cap|58 and bears against the inner end surface of the cap and latch 56 tonormally and yieldingly urge fthe latch in a clockwise direction, asviewed in Figure l2. When the parts are in the relative position shownin full lines in Figure 12, latch 66 is in its normal position andregisters with aperture 4| in collar 35. Upon the application of f'L'downward pressure on the top of cap EQ, the cap spring 38 in unit 2|and ange 29 that abuts the ner well known to the art. A perforatepartition 34 is located across tube I6 to protect the lamp againstdamage by instruments that may be inserted in the tube from the rearwardend thereof.

A collar 35 embraces endoscopic tube i6 and is secured thereto by one ormore set screws 36 (Figure 2). This collar carries a pairofdiametrically opposed conduits 31` and 38 that communicate withcorresponding ports 31' and 38 in tube I6. As shown in Figure 3, conduit38 is provided with a petcock 39 to control the flow of irrigating uidfrom a convenient source (not shown) through conduit 38, port 38' andtube I6 in the order named. Spent irrigating liquid is withdrawn by theinstrument through the interior of tube IB, port 31' and conduit 31.Collar 35 lhas a plurality of circumferentially spaced apertures, a pairof to move cap 6D upwardly and return the parts j to their normalrelative position.

Another of the earlier referred to devices of the invention is shown indetail in Figures 7-10, inclus-ive. This device contemplates a telescopecomprising a tubular stem 1|, an objective lens 12 and a conventionaleyepiece 13. Objective lens 12 constitutes one of the lenses of a.systemy` otherwise not shown, but which may be the same as or s-imilarto the arrangement shown in Reinhold H. Wappler Patent No. 1,021,809granted April 2, 1912, and adapted to command a field of visiongenerally at` right angles to the anis of stem 1|.

The telescopeA is adapted to be carried ina" housing 14 having alongitudinal bore 15 for the reception of stem 1|. The telescope issecured to the housing by a threaded connection (not shown) formedbetween eyepiece 13 and the rear-v ward end of housing 14, or in anyother desired manner. Housing 14 has an integral forwardly taperedfrustro-conical end portion 16 insertable in locking unit 50, whichengages a pair of oppositely arranged, laterally projecting lock pinsy farianna..

58 .may bethe same asV is .taughtinthefabove mentioned .Reinhold H.t'Viapplei-Patent y No'. 1,880,551.

ESecured to housing 14 is a pair. ofA spaced catheter guide conduit-.s18 (Figure '10); each of Which'communicates with the interior` of endo-:4scopic tubef I6 when-'the instrument is. fully assembled, as isdepictedzin Figure 2. Intermediate conduits `18 lis a thirdV conduit 19.thatis-f also adapted to' communicate with theinterior of @tube|g-.andzthatz serves as a guide'for an operating instrument (not shown).When the instrument is tofbe usedrfforcatheterizing purposes, itisadvantageous to employ a, removable longitudinal n80. to guide thecatheters during their movementfalong the interior of tube I8 and toprevent the'catheters from 'beeomingz'entangled with each other or withother devices disposed in the endoscopic y-tubel Removable fin-80 snapson 'the forward .portion of telescope tube 1| Vand may'rbeof the samegeneral character as vthecorifesponding fm disclosed in Reinhold: H.Wappler :Patent No. 1,303,135 granted May 6, 1919.

'Within housingf14 isacOmpartment'or chamberl'iFigures 7 and 9).'Housing 14 includes a cover member-82 that is maintained in position- A`defiector plate85 vfor directing catheters or operating instruments'through a fenestra is pivotedv intermediate its ends to telescope tube1|, as at 86, and is disposed in the eldr of vision of the telescope.`Reference is now had to Figures '7, 8 and 9 which illustrate details ofconstruction of the elements that cooperate to actuatedeflectorfplate-f85 and positivelymaintain the same in desired positionat the will of the operator. In this connection, Iprovide a,pairofshafts or rods 81 slidable through guide tubes 88 welded orotherwise secured to telescope tube 1| Shafts 81 are parallel to eachother and to the axis'of telescope tube 1|,.and are pivoted at theirforward ends 89 to deiiector plateI 85 and secured at their rearwardends 90 to opposite sides of a block 9| reciprocable in compartment 8|.Block 9| has a longitudinal bottom groove 92 to permit its free movementalong telescope tube 1| As is best shown in Figure 8, block 9| is alsoprovided with a transverse through slot 93 that merges with alongitudinal partial top slot 94. When the block 9| is at itsrearward-most position, as shown in Figure '1, it cooperates with shafts81 to maintain deflector plate 85 in retracted position, as shown infull lines in that gure and in Figure 2. As block 9| is moved forwardlyor toward the left (Figure '1), it cooperates with shafts 81 and pivotconnections 89 and 86 to tilt deector plate 85 in a counterclockwisedirection, the fully protracted position of the deiiector plate beingindicated by the dotdash lines in Figures 2 and 7.

The position of block 9| within compartment 8| and, therefore, theposition of deector plate 85 with respect to telescope tube 9| aredetermined by a threaded control rod 95. Control rod 95 engages e,tapped bore 96 formed in a lug 91 integral with cover member 82 andextending obliquely and rearwardly of the axis of telescope tube 1|.Preferably integral with control rod slotz94, and that carries aheader-disc 99=.which registers'with.s101193. -Control rod 95 isn-alsoprovidedwith 2,.,knurledactuatingknob |09 opery able from thefexteriorof the .instrument :With theparts-in the relative position shownfinFigures '7 and 9, and eupon: manipulation of knob flf-in a, clockwisedirection (Figure 9), control-rod w85.

stem' 98 and 'head`- 99 are `rotated land f move Aforwardly anddownwardly, thereby'.v moving block 9 forwardly; along; telescope tube 1and ii'itiat ing protracting movement of deectorplateli about pivotli.vIt will `be apparent from an examinationof Figure 7. that with thearrange` ment just described, deflector platemay @be disposed in anyidesiredzposition between" fully'` protracted and fullyretractedposition' in 'respense to corresponding .increments .oflrotationof control rod 95. in opposite; directions.

illustrated,.fenestras |1 andr|8 .arevforme'd .Y .apart in endoscopictube I6. Aperturesfor notches 4| and 4i! are likewise disposed-180.8`from eachother. v`With--1the parts assembled as shown.

in :Figures land 2, fenestra r|.1: alone is in lthe field.. ofnv'isionof ythe telescope, whiley latch 680i dete'nt' means-55 islin-Iregistrationwith notch 4| to 'prevent :relative rotation between'the telescopeand tube I8. Tov bring'fenestra |8" in :thev field ofvision of the telescope,V it is. merely necessary "to .f release latchiifrom. notch 4| androtate :the`

telescope through 1:80-1with"respect.to tube '|6,

permittinglatch 68 ofthe detentl means to 'lentes into registration withnotch 42.

Thus it will ,be` seen that'the `construction herein vshownandfdescribed. is well adapted to accomplish the l'objects ofthepresentinvention. It

willbe understood, however, that the invention may `be'embodiedotherwisecthan 'here shown;

and lthat-.in the :form illustrated certainobvious changes in`construction :may ibef made.A There fore, r1 i do 1 not wish'ito be`limited'precisely to the construction hereinxshown except asmayberequired by `the 'appended claims :considered withreferencetothepriorart.

1. :In an'instrument of ythecharacter described,

an endoscopic tube'and a forward extension for said tube' comprising afirst unitfhavingzonefend secured..to the front end of said tube and asec'- ondunit, one` rend iof ysaid .f second. `unittforming a universalconnection with the other end of said first unit.

2. In an instrument of the character described, an endoscopic tube and aforward extension for said tube comprising a first unit secured at itsrearward end to the front end of said tube and a second unit closed atits forward end and open at its rearward end, the rearward end of saidsecond unit engaging the forward end of said rst unit in a manner toform a universal connection therewith.

3. In an instrument of the character described, an endoscopic tube and aforward extension for said tube comprising a rst unit secured at itsrearward end to the front end of said tube, said first unit including arounded forward portion, and a hollow second unit having a closedforward end and an open rearward end, said rearward end of said secondunit embracing said rounded portion of said rst unit and forming auniversal connection therewith.

4. In an instrument of the character described, an endoscopic tube and aforward extension for said tube comprising a rst unit secured at itsrearward end to the front endof said tube, said arida'hllow second unithavinga closed forward end'and an `open rearward Iend,l said rearwardend of said `secondunit"embracing said rounded portion of f said secondunit and forming a universal/connection `'therewithyand' resilient meanswithinsaid second'unit biasingr the same in a direction away from saidfirst unit. v "i 5. In an instrument of the character described,ari'endoscopic tube, a forward extension for said tube'icomprising a'rstunithaving one end secured -t'o the front end ofv said tube and a secondunit having one end swivelly connected to the otherend of said first'unit, a lamp having at least' a portion thereof disposed'fin' the tube,resilient means bearing against saidV rst unit and said lamp'formovingsaid lamp in -a direction' toward" the rear ofsaid tube, and means forlimiting movement of said'lamp in said direction.

'6. In an instrument of the character described, a first devicecomprising an endoscopic tube having at leastone lateral fenestra, asecond device comprising a telescope having its forward portion in saidfirst device and capable of including said fenestra in 'its' field ofvision, a third device rotatably coupled to the rst device and removablyattached to the second device to respectively permit relative angularmovement and prevent 'axiail movement between said first and saidsecond' device, and means for preventing relative rotationy between saidrst and second devices when the same are in angular position.

'7. 4In an instrument of the character described, a first devicelcomprising an endoscopic tube having atleast one lateral fenestra, asecond device comprising a telescope having its forward portion in saidfirst device and capable of including said fenestra in its field ofvision, a third device rotatably coupled to the first device andremovably attached to the second device to respectively permitrelativeangular movement and prevent axial movement between said rst andsaid second device, and spring-pressed detent means for preventingrelative rotation between said first and second devices when the sameare in a predetermined. relative angular position.

8. In an instrument of the character described, a first devicecomprising an endoscopic tube having 'a'pluralityof lateral fenestrasformed therein a predetermined relative "said -fenestras is and spacedtherearound,:a telescope having a portion in vsaid first deviceand'capable of including z. anyone of said fenestras in its field ofvision y depending on' the relative angular position of said telescopeand said first'device, a second device" rotatably coupled to-said rstdevice and removably attached to said telescope to respectively permitrelative angular movement and prevent axial movement between said firstdevice and said telescopeyand means carried by one of said devices andcooperating with the vother of said devices t0 prevent relative rotationbetweensaid' first device and'saidtelescope when the same are inrelativel angular positions in which any onev of in the eld of vision ofsaid telescope.

9. In an instrument of the character described, a first devicecomprising an endoscopic tube having a plurality of lateral fenestrasformed therein vv:and spaced therearound, a telescope having a portionin said rst device and capable of including any one of said fenestras inits field of vision depending on the relative angular position of saidtelescope and said rst device, a second device ,rotatably coupled tosaid rst device and remov ably attached to ysaid telescope torespectively permit relative angular movement and prevent axial movementbetween said first device and said telescope, one of said devices havinga plurality-- tof spaced apertures, and releasable detent means carriedby the other of saidldevicessaid detent" means registering with one ofsaid apertures when said 'devices are'in a corresponding relativeangular position to prevent relative rotation 'between lsaid devices,said aperturesand detent means being 'so arranged as to eiiect suchregistration when each of said fenestras is in the fieldof vision ofsaid telescope.

` FREDERICK J. WALLACE.

REFERENCES CITED The following references are of record in the fi1e"ofpatent: UNITED STATES PA'rEN'I's` Number Wolf Oct. 7, 1941

